Will Extracorporeal Modalities Replace Conventional Ventilators?

As
extracorporeal modalities expand into nontraditional support of critically ill
patients, the question of “Will Extracorporeal
Modalities Replace Conventional Ventilators?” becomes a valid and interesting
thought.

A recent article discussed ECCO2R as an Adjunct to Ventilation in ARDS. Extracorporeal CO2 removal, also referred to as respiratory dialysis, has demonstrated the feasibility of its use as an adjunct to ultra-lung protective ventilation (3-4 ml/kg IBW) in ARDS patients. At blood flows of 450 ml/min to 1000 ml/min, ECCO2R assists in the removal of CO2, thereby allowing the clinician to reduce excessive ventilator pressures that contribute to ventilator induced lung injury. The multicenter, international, randomized control trial SUPERNOVA denoted a 73% survival rate at 28 days and a 62% survival rate at hospital discharge for those enrolled. While consideration must be given to documented and potential serious adverse events associated with ECCO2R (brain hemorrhage, pneumothorax), it appears to be a viable adjunct therapy for the treatment of profound respiratory acidosis in ARDS patients. Full article can be found here.